Affective reactivity of speech and emotional experience in patients with schizophrenia.

Communication disturbances are exacerbated by stress in patients with schizophrenia, a phenomenon known as affective reactivity of speech. However, a subset of these patients, those with the deficit syndrome, is characterized by a diminished capacity to experience emotion. We examined affective reactivity in the natural speech of schizophrenia patients with and without the deficit syndrome, with the expectation that deficit syndrome patients would evidence lower levels of affective reactivity. Two 10-min conversational speech samples were collected from each of 13 deficit syndrome patients, 22 nondeficit patients and 26 healthy control subjects. One speech sample from each participant was on the topic of emotionally negative, stressful memories, and the other was on emotionally positive, nonstressful memories. The audiotaped speech samples were analyzed blindly for frequencies of referential communication failure. All three groups showed significantly higher frequencies of communication disturbances in the emotionally negative speech sample than the positive speech sample. Nondeficit patients showed greater affective reactivity of speech than either deficit patients or controls. Conversely, deficit patients' speech was not more reactive to emotion than the speech of the control group. These results suggest that emotion-related variables mediate the relationship between stress and language symptom exacerbations in at least some patients with schizophrenia.